Massachusetts Removes Barrier For MedSpa Ownership by Nurse Practitioners

Bradford E. Adatto | 9.6.18

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In many states the corporate practice of medicine doctrine precludes a non-physician from owning and operating a MedSpa. Until recently the State of Massachusetts was such a state, unless you went through a rigorous process to become licensed by the Department of Public Health (“DPH”).  However, the DPH has recently altered their policy requiring nurse practitioners (“NPs”) to obtain a license to own and operate a MedSpa.

Many states, including Massachusetts, are dealing with rising healthcare costs and a shortage of primary care physicians. To combat this, these states look to utilize other highly trained and qualified healthcare professionals to lessen the burden on physicians.  Recently, this has taken the form of regulations that reduce the amount of physician supervision or oversight needed for NPs and other Advanced Practice Nurses in their practice.  Massachusetts is part of this trend. In 2014, the Massachusetts legislature passed a bill that removed the requirement for NPs to have their nursing practices supervised by a physician.  This was a major step toward practice autonomy for NPs, but NPs were still required to have physician supervision and review of their prescription practice.  Moreover, until recently, NPs faced another significant hurdle to practice autonomy.

Massachusetts requires that health care facilities and clinics, including MedSpas, first obtain a license from the DPH.  The clinic licensure process in Massachusetts is onerous, and it can take anywhere from six months to one year to obtain the license.  However, “Practitioners” who own their practice and provide the services are exempt from this requirement.  This group includes physicians and others whose license allows them to diagnose and treat issues “without limitations” within their profession. Previously, NPs were not included in the Practitioners definition, and therefore, were not exempt from and required to obtain a license for their MedSpa.

In a recent change of interpretation, the DPH now considers NPs to be exempt from obtaining a license for their MedSpa if they are the owner and provide the services rendered there.  To be clear, there has not been a change in the law at this time and NPs still must collaborate with a physician to supervise their prescription practice. This reduces the costs and burdens on NPs when starting a clinic or MedSpa and hopefully will inspire more NPs to start their own businesses while also protecting those who’ve already done so.

These changes track with the nationwide momentum towards NP practice autonomy.  Currently twenty-three states and the District of Columbia have granted their NPs and other Advanced Practice Nurses some independent practice authority. As other states move towards granting practice autonomy, this opens up many exciting opportunities for NPs to find new and innovative ways of serving their patients.

For further details on NP ownership rights, scope of practice, or collaboration requirements, please feel free to contact Bradford E. Adatto (badatto@byrdadatto.com). Thank you to Patrick O’Brien for the significant research and drafting contributions to this article.